The Home & Community-Based Services Waiver Program (HCBS) at St. Luke’s-Roosevelt Hospital Center provides intensive services, available twenty-four hours a day to seriously emotionally disturbed children at imminent risk of hospitalization. Services include respite care, skill building, family support, intensive in-home therapy, and crisis intervention.
The HCBS is the New York State Office of Mental Health’s option for children and adolescents with serious and complex emotional needs. It provides the highest level of care in an out patient setting. As an alternative to residential treatment, families can now choose to work with intensive support services to maintain their child at home and in the community. Families are expected to use these services for approximately eighteen months. Services are available for 132 families in New York (Manhattan) County.
The Goals of the Home and Community Based Services Waiver Program are:
- To serve children and adolescents with complex mental health needs in their own homes and communities.
- To focus on clinical determinations of needed services and supports, rather than financial determinations.
- To shift the focus of care to the family in the community and decrease the need for out-of-home placements.
- To increase the array of Medicaid reimbursable community-based services.
- To offer families a choice of providers.
- To use an individualized care services delivery approach. This means:
- Services are designed to address the unique needs and strengths of each child and family.
- Services are provided within the least restrictive setting.
- There is true partnership with families, with family involvement during all phases of services planning, delivery, and evaluation.
- Services are culturally relevant.
- No child should be found ineligible for services based solely on the severity of his or her presenting problem.
In order to be enrolled in HCBS, children and families must demonstrate eligibility in the following categories:
It must be demonstrated that the child:
- Is between ages of 5-17.9 years of age.
- Has a serious emotional disturbance, as determined by an Axis I (DSM-IV) diagnosis, a CGAS rating of 50 or below, and functional limitations for at least a year of the following areas: self-care, family life social relationships, self-direction/self-control, and learning ability.
- Is eligible for a residential treatment facility or intermediate inpatient care.
- Could be cared for in the community if provided access to HBCS services.
- Resided in, or could reside in, a viable and consistent living environment with parents or guardians who are able and willing to participate in the HCBS Waiver and support the child in his or her home and community.
The child must be eligible for Medicaid under the HCBS Waiver (i.e. currently enrolled in Medicaid or able to meet federal eligibility standards). For purposes of the Waiver program, Medicaid eligibility is calculated based solely on the child's income without regard to parental income. Child income may be no higher than $767 per month.
It must be reasonable to expect that the child could be served in the community at the federally approved average yearly cost. In addition to existing Medicaid reimbursable services, the following services are available to children and families enrolled in the Waiver:
Individualized Care Coordination:
Assessment, Service Plan Development, Linkages with community agencies and Advocacy, Monitoring, and clinical consultation with other mental health providers.
Intensive Home Based Services:
Goal-orientated interventions designed to support the family’s strengths and build new skills in managing the child’s special needs.
In-home or out-of-home respite provided by trained workers.
Professional crisis response available 24 hours a day.
Family Support Services:
Includes parent education, socialization opportunities, and support groups.
Activities to help the child develop functional skills.
For Information Contact
Cathryn Passman, Director CCMHS
Phone: (212) 636-1476
Fax: (212) 523-5761
James Morrissey, Assistant Clinical Director, CCMHS